Full Text of HB3154 94th General Assembly
HB3154ham001 94TH GENERAL ASSEMBLY
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Rep. Rich Brauer
Filed: 4/12/2005
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09400HB3154ham001 |
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LRB094 07743 DRJ 44586 a |
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| AMENDMENT TO HOUSE BILL 3154
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| AMENDMENT NO. ______. Amend House Bill 3154 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Ambulatory Surgical Treatment Center Act is | 5 |
| amended by changing Section 6.5 as follows:
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| (210 ILCS 5/6.5)
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| Sec. 6.5. Clinical privileges; advanced practice nurses. | 8 |
| All ambulatory surgical treatment centers (ASTC) licensed | 9 |
| under this Act
shall
comply with the following requirements:
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| (1) No ASTC policy, rule, regulation, or practice shall be | 11 |
| inconsistent
with the provision of adequate collaboration, | 12 |
| including medical direction of
licensed
advanced practice | 13 |
| nurses, in accordance with Section 54.5 of the Medical
Practice | 14 |
| Act of 1987.
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| (2) Operative surgical procedures shall be performed only | 16 |
| by a physician
licensed to
practice medicine in
all its | 17 |
| branches under the Medical Practice Act of 1987, a dentist
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| licensed under the
Illinois Dental Practice Act, or a | 19 |
| podiatrist licensed under the Podiatric
Medical Practice Act of | 20 |
| 1987,
with medical staff membership and surgical clinical | 21 |
| privileges granted by the
consulting
committee of the ASTC. A | 22 |
| licensed physician, dentist, or podiatrist may
be assisted by
a | 23 |
| physician licensed to practice medicine in all its branches, | 24 |
| dentist, dental
assistant,
podiatrist, licensed
advanced |
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LRB094 07743 DRJ 44586 a |
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| practice nurse, licensed physician assistant, licensed
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| registered nurse, licensed practical nurse,
surgical
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| assistant, surgical technician, or other individuals granted | 4 |
| clinical
privileges to assist in surgery
by the consulting | 5 |
| committee of the ASTC.
Payment for services rendered by an | 6 |
| assistant in surgery who is not an
ambulatory surgical | 7 |
| treatment center employee shall be paid
at the appropriate | 8 |
| non-physician modifier
rate if the payor would have made | 9 |
| payment had the same services been provided
by a physician.
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| (3) The anesthesia service shall be under the direction of | 11 |
| a physician
licensed to practice
medicine in all its branches | 12 |
| who has had specialized preparation or experience
in the area
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| or who has completed a residency in anesthesiology. An | 14 |
| anesthesiologist, Board
certified or
Board eligible, is | 15 |
| recommended. Anesthesia services may
only be
administered | 16 |
| pursuant to the order of a physician licensed to practice | 17 |
| medicine
in all its
branches, licensed dentist, or licensed | 18 |
| podiatrist.
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| (A) The individuals who, with clinical privileges | 20 |
| granted by the medical
staff and ASTC, may
administer | 21 |
| anesthesia services are limited to the
following:
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| (i) an anesthesiologist; or
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| (ii) a physician licensed to practice medicine in | 24 |
| all its branches; or
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| (iii) a dentist with authority to administer | 26 |
| anesthesia under Section
8.1 of the
Illinois Dental | 27 |
| Practice Act; or
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| (iv) a licensed certified registered nurse | 29 |
| anesthetist ; or | 30 |
| (v) a registered nurse under the conditions set | 31 |
| forth in item (D) .
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| (B) For anesthesia services, an anesthesiologist
shall
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| participate through discussion of and agreement with the | 34 |
| anesthesia plan and
shall remain physically present and be
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LRB094 07743 DRJ 44586 a |
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| available on
the premises during the delivery of anesthesia | 2 |
| services for
diagnosis, consultation, and treatment of | 3 |
| emergency medical
conditions.
In the absence of 24-hour | 4 |
| availability of anesthesiologists with clinical
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| privileges, an alternate policy (requiring
participation, | 6 |
| presence,
and availability of a
physician licensed to | 7 |
| practice medicine in all its
branches) shall be
developed | 8 |
| by the medical staff consulting committee in consultation | 9 |
| with the
anesthesia service and included in the medical
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| staff
consulting committee policies.
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| (C) A certified registered nurse anesthetist is not | 12 |
| required to possess
prescriptive authority or a written | 13 |
| collaborative agreement meeting the
requirements of | 14 |
| Section 15-15 of the Nursing and Advanced Practice Nursing | 15 |
| Act
to provide anesthesia services
ordered by a licensed | 16 |
| physician, dentist, or podiatrist. Licensed certified
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| registered nurse anesthetists are authorized to
select, | 18 |
| order, and
administer drugs and apply the appropriate | 19 |
| medical devices in the provision of
anesthesia
services | 20 |
| under the anesthesia plan agreed with by the
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| anesthesiologist or, in the absence of an available | 22 |
| anesthesiologist with
clinical privileges,
agreed with by | 23 |
| the
operating physician, operating dentist, or operating | 24 |
| podiatrist in accordance
with the medical
staff consulting | 25 |
| committee policies of a licensed ambulatory surgical | 26 |
| treatment
center.
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| (D) A registered nurse may administer conscious | 28 |
| sedation, as defined in the Medical Practice Act of 1987, | 29 |
| under the following conditions:
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| (1) The registered nurse has privileges granted by | 31 |
| the medical staff and ASTC to administer conscious | 32 |
| sedation.
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| (2) The registered nurse is under the direct | 34 |
| supervision of the operating physician or dentist |
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| during the delivery conscious sedation.
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| (3) The registered nurse maintains current | 3 |
| Advanced Cardiac Life Support certification.
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| (4) The operating physician has training and | 5 |
| experience in the delivery of anesthesia services to | 6 |
| patients by either possessing clinical privileges at | 7 |
| the ASTC to administer anesthesia or completing a | 8 |
| minimum of 8 hours of continuing education (CME) in the | 9 |
| delivery of anesthesia, including the administration | 10 |
| of conscious sedation within each 3-year license | 11 |
| period.
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| In addition, the operating physician or dentist with | 13 |
| authority to administer anesthesia under Section 8.1 of the | 14 |
| Illinois Dental Practice Act must maintain current Advanced | 15 |
| Cardiac Life Support certification. This training and | 16 |
| experience must be documented in the operating physician or | 17 |
| dentist clinical privilege file.
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| (Source: P.A. 93-352, eff. 1-1-04.)
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| Section 10. The Medical Practice Act of 1987 is amended by | 20 |
| adding Section 54.7 as follows: | 21 |
| (225 ILCS 60/54.7 new) | 22 |
| Sec. 54.7. Anesthesia services. | 23 |
| (a) Any physician may order and administer anesthesia | 24 |
| services in accordance with his or her training or experience. | 25 |
| (b) In a hospital setting, anesthesia services shall be | 26 |
| administered in accordance with Section 10.7 of the Hospital | 27 |
| Licensing Act. | 28 |
| (c) In an ambulatory surgical treatment center, anesthesia | 29 |
| services shall be administered in accordance with Section 6.5 | 30 |
| of the Ambulatory Surgical Treatment Center Act. | 31 |
| (d) In a physician's office, anesthesia services shall be | 32 |
| administered in accordance with the following: |
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| (1) In a physician's office, the operating physician | 2 |
| shall have training and experience in the delivery of | 3 |
| anesthesia services in order to administer anesthesia or to | 4 |
| enter into a practice agreement with a certified registered | 5 |
| nurse anesthetist (CRNA) to provide anesthesia services in | 6 |
| the office pursuant to Section 54.5 of the Medical Practice | 7 |
| Act and Section 15-25 of the Nursing and Advanced Practice | 8 |
| Nursing Act. When an anesthesiologist is administering | 9 |
| anesthesia in a physician's office, the operating | 10 |
| physician is not required to have the training and | 11 |
| experience set forth in paragraph (2). A "physician's | 12 |
| office" is any practice location not regulated by Section | 13 |
| 10.7 of the Hospital Licensing Act or Section 6.5 of the | 14 |
| Ambulatory Surgical Treatment Center Act. | 15 |
| (2) The training and experience requirements may be met | 16 |
| in the manner specified in either subparagraph (A) or | 17 |
| subparagraph (B): | 18 |
| (A) The physician maintains clinic privileges to | 19 |
| administer anesthesia services in a hospital licensed | 20 |
| in accordance with the Hospital Licensing Act or an | 21 |
| ambulatory surgical treatment center licensed in | 22 |
| accordance with the Ambulatory Surgical Treatment | 23 |
| Center Act; or | 24 |
| (B) Completion of continuing medical education: | 25 |
| (i) For conscious sedation only, the physician | 26 |
| shall complete a minimum of 8 hours of continuing | 27 |
| medical education (CME) in delivery of anesthesia, | 28 |
| including the administration of conscious sedation | 29 |
| within each 3-year license renewal period. | 30 |
| (ii) For deep sedation, regional anesthesia, | 31 |
| or general anesthesia, or any combination of | 32 |
| those, a physician shall complete a minimum of 34 | 33 |
| hours of continuing medical education in the | 34 |
| delivery of anesthesia services within each 3-year |
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| license renewal period. Fulfillment of this | 2 |
| requirement shall satisfy the requirement of | 3 |
| subdivision (2)(B)(i) for the administration of | 4 |
| conscious sedation. | 5 |
| (iii) A continuing medical education program | 6 |
| shall be conducted by a university, professional | 7 |
| association, or hospital as a formal CME program. | 8 |
| (3) In a physician's office where anesthesia is | 9 |
| administered, all operating physicians and | 10 |
| anesthesiologists shall obtain Advanced Cardiac Life | 11 |
| Support (ACLS) certification and shall thereafter maintain | 12 |
| current ACLS certification. If the physician enters into a | 13 |
| practice agreement with a CRNA, the CRNA shall also have a | 14 |
| current ACLS certification. | 15 |
| (4) The ACLS certification and the physician training | 16 |
| and experience required by this Section shall be documented | 17 |
| in the written practice agreement between the physician and | 18 |
| the CRNA. | 19 |
| (5) The continuing medical education required in | 20 |
| paragraph (2) and the ACLS training required in paragraph | 21 |
| (3) may be applied to fulfillment of the 150 hours of | 22 |
| continuing medical education required for renewal of a | 23 |
| license. | 24 |
| (6) For the provision of anesthesia services, the | 25 |
| operating physician or dentist shall participate through | 26 |
| discussion of and agreement with the anesthesia plan and | 27 |
| shall remain physically present and be available on the | 28 |
| premises during the delivery of anesthesia services for | 29 |
| diagnosis, consultation, and treatment of emergency | 30 |
| medical conditions. | 31 |
| (e) "Conscious sedation" means a drug-induced depression | 32 |
| of consciousness during which patients respond purposefully to | 33 |
| verbal commands, either alone or accompanied by light tactile | 34 |
| stimulation. No interventions are required to maintain a patent |
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| airway and spontaneous ventilation is adequate. Cardiovascular | 2 |
| function is maintained.
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| Section 99. Effective date. This Act takes effect upon | 4 |
| becoming law.".
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